CHEWs bring Reading Glasses for Masses in Adamawa State, Nigeria
Context for the Idea
Presbyopia is an irreversible, normal physiologic condition that impairs the ability to see clearly at near. It is estimated that there were 1.04 billion people globally with presbyopia in 2005, 517 million of whom had no spectacles or inadequate spectacles. Of these, 410 million were prevented from performing near tasks in the way they required. Vision impairment from uncorrected presbyopia predominantly exists (94%) in the developing world.” Though data on prevalence of presbyopia in Nigeria is limited, a study in Tanzania by Patel et al. showed that 62% of people aged 40 years and older are presbyopic and 94% of presbyopes are not having corrective near vision glasses.
However, most of the population in rural areas does not have access to simple good quality and affordable pair of presbyopic glasses, which is a simple solution to this problem and can have high impact on the quality of life and daily living. An impact evaluation, case control study conducted by Vision Spring (a not for profit organization), in Andhra Pradesh, India on the impact of reading glasses showed that those wearing reading glasses reported significantly higher monthly income growth (20%) and productivity (34%) as compared to those not wearing reading glasses. It is thus prudent to focus on increasing the availability of reading glasses for rural population.
This paper proposes a public private partnership model for providing reading glasses and addressing the prevalence of presbyopia in rural areas. In the pilot phase, the partner NGO Tulsi Chanrai Foundation would supply good quality and affordable presbyopic glasses @ USD 1.5 a pair and provide training to Community Health Extension Workers (CHEWS) in six Local Government Areas in Adamawa State. TCF would provide a one day training initially, followed by a refresher training, to CHEWs and other health care workers, that would empower the workers to screen individuals in the communities with vision difficulties and provide reading glasses to presbyopic individuals based on a Near Vision chart that is available in local languages (Specimen attached). This program envisages in identifying vision problems, provision of reading glasses for presbyopia to deprived and deserving populations at affordable prices, thereby improving the quality of life of elderly underprivileged in rural settings.
Implementation Plan: The schematics of implementation plan.
Key deliverables of Tulsi Chanrai Foundation
- Training of CHEWs, PHC Coordinators, others on screening individuals with vision difficulties, and providing reading glasses to presbyopic individuals based on a Near Vision chart in local language.
- Orientation of Medical Officers of PHCs/Ophthalmic nurses regarding the project, so as to enable them to supervise and provide support to CHEWs in case of difficulties
- Setting up a mechanism for CHEWs support in case of handling difficult cases.
- Complete Supply Chain management up to LGA level, distribution of reading glasses to PHC coordinators – Initially one kit of 20 glasses/ CHEW and later as per need.
- Conducting quarterly supportive supervision workshops at LGA levels.
- Providing a status update of the implementation of the project on a quarterly basis and a detailed report of the implementation of the project at the end of the year along with an evaluation report of the project, based on scientifically approved parameters.
- Development and distribution of Information Education and Communication (IEC) tools to CHEWs
Technical/ Programmatic Support
TCF eye care Programme would monitor the implementation and subsequently monitor the aspects of the programme, therefore a technical team from TCF, along with the designated personnel from the state would monitor the programme closely. A programme manager to oversee the activity would be placed in the state, for technical support, state would provide a suitable accommodation for the person to stay, his other expenses would be supported by TCF. Success of the programme implementation is only possible by close monitoring and required assistance from the state in creating an enabling environment.
Holden, B et al., (2008) Global Vision Impairment Due to Uncorrected Presbyopia. Arch Ophthalmol. 26(12):1731-1739